The medical humanitarian organization Médecins Sans Frontières | Doctors Without Borders has announced that it is shutting down its operations in Somalia due to ongoing attacks on its staff by armed groups.

The international charity, which has operated continuously in Somalia since 1991, will close all medical programs in the country — through which more than fifteen hundred staff provide a range of services, including primary and maternal health care, malnutrition treatment, surgery, immunizations, clean water, and relief supplies. MSF increasingly has had to negotiate minimum guarantees of respect for its humanitarian mission with the same militant groups and civilian authorities that have been involved in or tacitly approved assaults against and abductions and killings of MSF staff. "We are ending our programs in Somalia because the situation in the country has created an untenable imbalance between the risks and compromises our staff must make, and our ability to provide assistance to the Somali people," said Dr. Unni Karunakara, MSF's international president.

Since 1991, a total of sixteen MSF staff have been killed in dozens of attacks on the organization's ambulances and medical facilities. Recent attacks include the December 2011 murder of two aid workers in Mogadishu; the convicted killer was released early. In addition, two female MSF staff members were abducted from the Dadaab refugee camps in Kenya, held in captivity in south-central Somalia for nearly two years, and released only last month.

"Ultimately, civilians in Somalia will pay the highest cost," said Karunakara. "Much of the Somali population has never known the country without war or famine, and they already receive far less assistance than is needed. The armed groups' targeting of humanitarian aid, and civilians leaders' tolerance of these abuses, [have] effectively taken away what little access to medical care is available to the Somali people."